The Johns Hopkins-University of Maryland Center for Research on Services for Severe Mental Illness (SMI Center) was established in 1987 as a collaborative effort of the School of Hygiene and Public Health and the School of Medicine of the Johns Hopkins University, and the Center for Mental Health Services Research of the Department of Psychiatry at the University of Maryland. It works collaboratively with the Maryland State Department of Health and Mental Hygiene and the National Alliance for the Mentally Ill (NAMI), as well as providers and payers. The Center has adopted an integrating theme, "Improving Quality of Care and Patient Outcomes," which will involve the Center in: (a) further developing and refining methods to improve the match between patient needs and services, (b) developing guidelines for the financing and organization of care that meet cost and effectiveness criteria taking into account variations in need and available resources, and (c) testing dissemination strategies to close the gap between research and practice. The specific research aims of the Center are directed at four policy relevant areas: (1) Developing and evaluating evidence-based quality of care criteria for services to persons with SMI and, where evidence is insufficient, evaluating the impacts of service alternatives on patient outcomes, service utilization, and costs; (2) Examining the role of financing mechanisms as a means to encourage efficiency, assure access to appropriate care for persons with SMI, and provide incentives for enhancing patient outcomes; (3) Examining alternative organizational system approaches for managing resources and coordinating services to persons with SMI, and evaluating their impact on quality of care, utilization, patient outcomes, and cost; and (4) Assessing the gaps between current practices and evidence-based quality of care criteria and evaluating the cost and effectiveness of promising dissemination interventions to improve quality of care and patient outcomes. In the next five years core support will make it possible to: (a) strengthen and extend research initiatives related to improving the quality of care and patient outcomes and (b) develop and test effective methodologies for dissemination of research and closing the gap between research and the care received by persons with SMI.